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Friday, August 26, 2016

Dear friends we are happy to present you new article by world known experts in Respiratory Medicine Maria Gabriella Matera, Clive Page, Paola Rogliani, Luigino Calzetta, Mario Cazzola: Therapeutic Monoclonal Antibodies for the Treatment of COPD (article from last issue of Drugs journal)!

Chronic obstructive pulmonary disease (COPD) is a disorder characterized
by a complex chronic inflammatory response that is largely poorly
responsive to treatment with corticosteroids. Consequently, there is a
huge need to find effective anti-inflammatory agents for the treatment
of patients with this disease. Inhibition of cytokines and chemokines or
their receptors using monoclonal antibodies (mAbs) could be a potential
strategy to treat the inflammatory component of COPD. In this article,
we review the therapeutic potential of some of these mAbs; however, to
date there has been little or no therapeutic effect of any mAb directed
against cytokines or chemokines in patients with COPD. This may reflect
the complexity of COPD in which there is no dominant role for any single
cytokine or chemokine. It is also likely that since the umbrella term
COPD covers many endotypes having different underlying mechanisms, mAbs
directed towards specific cytokines or chemokines should be tested in
restricted and focused populations.

Mesothelioma
is a type of cancer that affects the mesothelium, a tissue that lines
most of the body’s organs. The most common type is pleural mesothelioma,
cancer of the pleura or lining of the lungs. This cancer is aggressive,
takes years to develop into recognizable symptoms, and is often
diagnosed only after it is too late to expect treatment to cure it. For
most people, this terrible illness is a death sentence.

Causes and Risk Factors

Doctors
and researchers cannot pinpoint an exact cause of mesothelioma, which
is not a common type of cancer. It is likely an interaction of several
factors that leads to the development of malignant tumors. These include
genetics, environmental factors, lifestyle, and health. While the cause
cannot be made definite, there is one huge risk factor for mesothelioma that stands apart from all others: asbestos exposure.

Asbestos
is a natural mineral that has been used for hundreds of years in a
number of applications from insulation to shipbuilding to car brakes. It
has been used for so long and in so many different ways because it is
very strong and resistant to heat. Because asbestos is fibrous, when it
is broken apart, particles get in the air and can be inhaled.

It
is this inhalation that is the number one risk factor for mesothelioma.
People who worked in conditions that included asbestos fibers and
inadequate safety gear are at serious risk for the cancer. It can take
20 years and more for the cancer to develop and show symptoms and too
many people are surprised later in life with this terrible diagnosis.

Treatment for Mesothelioma

It
is unfortunate that this type of cancer is so aggressive and often gets
diagnosed in later stages; many people don’t survive and treatments may
only extend a patients’ life a little longer. Still, many opt for
treatments to live longer and to be more comfortable.Treatment options for pleural mesothelioma include
surgery to remove the cancerous tissue or even an entire lung,
chemotherapy or radiation to kill cancer cells, and clinical trials with
new medications and therapies, including gene therapy.

Mesothelioma and Legal Action

Many
people diagnosed with mesothelioma were exposed to asbestos at work.
This especially includes people who worked on ships or in construction
with asbestos insulation. Most of these workers who end up with this
terrible type of cancer had no idea that they were exposed to asbestos
fibers or that they were at risk. They feel wronged and many want
justice.

Mesothelioma lawsuits continue
to rise because of these people suffering from cancer. They are working
with lawyers to sue their employers, to file claims, and to seek
compensation from asbestos trust funds. Their employers failed in a
responsibility to provide them with a safe workplace, and now they are
getting both compensation and justice for their suffering.

A Survivor’s Story

Katherine
Keys is a woman who battled the odds and won. Diagnosed with pleural
mesothelioma at age 49, she was given just two years to live, even
though the cancer was rated as stage 1. Determined to fight and survive,
Katherine underwent surgery to remove her right lung along with its
pleura. She also had radiation treatment for several months.

Katherine
is in remission and is now down to only annual follow ups to make sure
that the cancer has not returned. Losing a lung has been difficult and
she experiences pain and certain limitations, but is happy to be alive.
Her story is one that brings hope to others battling this terrible type
of cancer.

Sunday, August 21, 2016

Exercise-induced bronchoconstriction (EIB) describes
acute airway narrowing that occurs as a result of exercise. It can occur in
patients with asthma as well in patients who were previously not diagnosed with
the disease.

Many studies have been performed in elite-level athletes that have
documented prevalence of EIB varying between 30 and 70%, depending on the
population, sport type, studied and methods implemented but no relationship
were currently found regarding height, weight, age and gender. The
clinical symptoms of EIB include coughing, wheezing, chest pain and dyspnoea
following an exercise but can often can be absent or not noticed by the athlete.
Further examination often reveals some degree of atopy. But
it should be noted that self-reported symptoms are not always present and
asymptomatic forms are very common.

Highly trained athletes tend to be frequently and for a
long period of time exposed to cold air during winter training, to pollen
allergens in spring and summer, different chemical substances used as
disinfectants in swimming pools. These factors probably explain why elite
athletes so often have EIB. This condition is most commonly found in endurance
sports, such as cycling, swimming, or long-distance running. The occurrences of
exercise-induced bronchospasm vary from 3% to 35% and depend on testing
environment, type of exercise used, and athlete population tested. Still the
highest risk for developing EIB in swimmers may be even higher, being 36%-79%.

Saturday, August 20, 2016

BackgroundProblems with the use of inhalers by patients were noted
shortly after the launch of the metered-dose inhaler (MDI) and persist
today. We aimed to assess the most common errors in inhaler use over the
past 40 years in patients treated with MDIs or dry powder inhalers
(DPIs).

MethodsA systematic search for articles reporting direct observation
of inhaler technique by trained personnel covered the period from 1975
to 2014. Outcomes were the nature and frequencies of the three most
common errors; the percentage of patients demonstrating correct,
acceptable, or poor technique; and variations in these outcomes over
these 40 years and when partitioned into years 1 to 20 and years 21 to
40. Analyses were conducted in accordance with recommendations from
Preferred Reporting Items for Systematic Reviews and Meta-Analyses and
Strengthening the Reporting of Observational Studies in Epidemiology.ResultsData were extracted from 144 articles reporting on a total
number of 54,354 subjects performing 59,584 observed tests of technique.
The most frequent MDI errors were in coordination (45%; 95% CI,
41%-49%), speed and/or depth of inspiration (44%; 40%-47%), and no
postinhalation breath-hold (46%; 42%-49%). Frequent DPI errors were
incorrect preparation in 29% (26%-33%), no full expiration before
inhalation in 46% (42%-50%), and no postinhalation breath-hold in
37% (33%-40%). The overall prevalence of correct technique was
31% (28%-35%); of acceptable, 41% (36%-47%); and of poor, 31% (27%-36%).
There were no significant differences between the first and second
20-year periods of scrutiny.ConclusionsIncorrect inhaler technique is unacceptably frequent and has
not improved over the past 40 years, pointing to an urgent need for new
approaches to education and drug delivery.Read more:http://journal.publications.chestnet.org/article.aspx?articleid=2514047&resultClick=3

Expert peer reviewers are the Sentinels of Science. They protect the
world from false findings that could set back advances in human
knowledge by decades.

That’s why we’re saluting the Sentinels of Science for Peer
Review Week 2016. At the end of Peer Review Week 2016, Publons will
announce the top contributors to peer review over the past year,
including the:

Top 10% of reviewers for each discipline

Top 3 overall contributors to peer review

Top 3 peer review contributors from the top five reviewing countries (by number)

Top 3 contributing editors (most manuscripts handled, by number)

Top 3 recognition advocates (top 3 editors that have invited reviewers to add a review record to Publons).

The top 10% of reviewers in each discipline will each receive a
Sentinel Badge on their profile, signifying their commitment on the
front lines of peer review over the past year.

Friday, August 19, 2016

We are happy to present you A 10-Year Follow-up Study of Survival after Endobronchial Valve Placement for Emphysema recently published in American Journal of Respiratory and Critical Care Medicine! This is one of the first long term follow up studies of Endobronchial Valves in Emphysema.

There is no effective therapy for
advanced emphysema at present. Hence, to find novel therapeutic methods
is needed. In the past decade, the new technology of bronchoscopic lung
volume reduction with endobronchial valves (EBV) has been applied to
clinical. Concerns of the less invasive bronchoscopic techniques to
treat emphysema to achieve the similar beneficial effects to LVRS have
been developed. Bronchoscopic
lung volume reduction with EBV are one-way blocking devices that stop
entry of air into the most affected emphysematous zone during
inspiration while allowing it to escape during expiration in order to
induce lobar atelectasis.

There are published several randomized controlled trials suggesting the role of EBV in patients with severe emphysema. Some non-controlled studies also demonstrated clinical improvements in lung volumes, health status and exercise
tolerance.

Kudos is a web-based service that helps researchers and their
institutions and funders to maximize the visibility and
impact of their published articles. Kudos provides a platform
for assembling and creating information to help search filtering,
for sharing information to drive discovery, and for measuring
and monitoring the effect of these activities.

Research can only reach its full potential if it is found, understood
and applied – by those within the field, by researchers in other
disciplines, by practitioners outside academia, even by the “curious
public”. Taking a little time to increase the visibility of work is
rising up the priority list for many researchers.

At
Kudos, we’ve spent the last two years helping researchers explain and
share their work to broaden its audience. A recent study has shown that
usage of our tools is correlated to 23% higher usage of the publications being explained and shared.

Now, we’re putting our money where our mouth is and launching the
“mobilization pledge” for researchers who share our belief that research
deserves a broader audience. We’ll donate one penny to Open Knowledge
International for everyone who signs up to the pledge by tweeting their
commitment (#mobilizeresearch) or by disseminating their work via Kudos.

The campaign will run from now until the end of the year – but don’t
wait! The sooner you join the campaign, the sooner you can help the word
spread far and wide and ensure that we will be digging deep at the end
of the year!

Sign up to “mobilize research” now – by doing one or both of the following:

Disseminate your work via Kudos.
We will count all shares from now to December towards the pledge. This
way, you get to give the visibility of your work a boost in the process.

Tuesday, August 9, 2016

Dear Respiratory friends we are happy to present you our new article on Prevalence and burden of comorbidities in COPD which appeared today in Respiratory Investigation.

Abstract

The
classical definition of Chronic Obstructive Pulmonary Disease (COPD) as
a lung condition characterized by irreversible airway obstruction is
outdated. The systemic involvement in patients with COPD, as well as the
interactions between COPD and its comorbidities, justify the
description of chronic systemic inflammatory syndrome. The pathogenesis
of COPD is closely linked with aging, as well as with cardiovascular,
endocrine, musculoskeletal, renal, and gastrointestinal pathologies,
decreasing the quality of life of patients with COPD and, furthermore,
complicating the management of the disease. The most frequently
described comorbidities include skeletal muscle wasting, cachexia (loss
of fat-free mass), lung cancer (small cell or non-small cell), pulmonary
hypertension, ischemic heart disease, hyperlipidemia, congestive heart
failure, normocytic anemia, diabetes, metabolic syndrome, osteoporosis,
obstructive sleep apnea, depression, and arthritis.

These complex
interactions are based on chronic low-grade systemic inflammation,
chronic hypoxia, and multiple common predisposing factors, and are
currently under intense research. This review article is an overview of
the comorbidities of COPD, as well as their interaction and influence on
mutual disease progression, prognosis, and quality of life.

Saturday, August 6, 2016

The clinical trial of Fevipiprant, conducted by experts at Leicester
University, found that it led to a big drop in the the symptoms of
asthma, improved sufferers’ lung function, reduced inflammation of the
lungs and also helped to repair the lining of patients’ airways.

Background

Eosinophilic airway
inflammation is often present in asthma, and reduction of such
inflammation results in improved clinical outcomes. We hypothesised that
fevipiprant (QAW039), an antagonist of prostaglandin D2 receptor 2, might reduce eosinophilic airway inflammation in patients with moderate-to-severe eosinophilic asthma.

Methods

We
performed a single-centre, randomised, double-blind, parallel-group,
placebo-controlled trial at Glenfield Hospital (Leicester, UK). We
recruited patients with persistent, moderate-to-severe asthma and an
elevated sputum eosinophil count (≥2%). After a 2-week single-blind
placebo run-in period, patients were randomly assigned (1:1) by the
trial pharmacist, using previously generated treatment allocation cards,
to receive fevipiprant (225 mg twice per day orally) or placebo,
stratified by the use of oral corticosteroid treatment and bronchoscopy.
The 12-week treatment period was followed by a 6-week single-blind
placebo washout period. The primary outcome was the change in sputum
eosinophil percentage from baseline to 12 weeks after treatment,
analysed in the intention-to-treat population. All patients who received
at least one dose of study drug were included in the safety analyses.
This trial is registered with ClinicalTrials.gov, number NCT01545726, and with EudraCT, number 2011-004966-13.

Findings

Between
Feb 10, 2012, and Jan 30, 2013, 61 patients were randomly assigned to
receive fevipiprant (n=30) or placebo (n=31). Three patients in the
fevipiprant group and four patients in the placebo group withdrew
because of asthma exacerbations. Two patients in the fevipiprant group
were incorrectly given placebo (one at the mid-treatment visit and one
throughout the course of the study). They were both included in the
fevipiprant group for the primary analysis, but the patient who was
incorrectly given placebo throughout was included in the placebo group
for the safety analyses. Between baseline and 12 weeks after treatment,
sputum eosinophil percentage decreased from a geometric mean of 5·4%
(95% CI 3·1–9·6) to 1·1% (0·7–1·9) in the fevipiprant group and from
4·6% (2·5–8·7) to 3·9% (CI 2·3–6·7) in the placebo group. Compared with
baseline, mean sputum eosinophil percentage was reduced by 4·5 times in
the fevipiprant group and by 1·3 times in the placebo group (difference
between groups 3·5 times, 95% CI 1·7–7·0; p=0·0014). Fevipiprant had a
favourable safety profile, with no deaths or serious adverse events
reported. No patient withdrawals were judged by the investigator to be
related to the study drug.

Description:The
American College of Physicians (ACP) developed this guideline to
present the evidence and provide clinical recommendations on the
management of chronic insomnia disorder in adults.

Methods:This
guideline is based on a systematic review of randomized, controlled
trials published in English from 2004 through September 2015. Evaluated
outcomes included global outcomes assessed by questionnaires,
patient-reported sleep outcomes, and harms. The target audience for this
guideline includes all clinicians, and the target patient population
includes adults with chronic insomnia disorder. This guideline grades
the evidence and recommendations by using the ACP grading system, which
is based on the GRADE (Grading of Recommendations Assessment,
Development and Evaluation) approach.Recommendation 1:ACP
recommends that all adult patients receive cognitive behavioral therapy
for insomnia (CBT-I) as the initial treatment for chronic insomnia
disorder. (Grade: strong recommendation, moderate-quality evidence)Recommendation 2:ACP
recommends that clinicians use a shared decision-making approach,
including a discussion of the benefits, harms, and costs of short-term
use of medications, to decide whether to add pharmacological therapy in
adults with chronic insomnia disorder in whom cognitive behavioral
therapy for insomnia (CBT-I) alone was unsuccessful. (Grade: weak
recommendation, low-quality evidence)Free full text:http://annals.org/article.aspx?articleid=2518955

Friday, August 5, 2016

The purpose of the Society of Anesthesia and Sleep Medicine guideline on
preoperative screening and assessment of adult patients with
obstructive sleep apnea (OSA) is to present recommendations based on the
available clinical evidence on the topic where possible. As very few
well-performed randomized studies in this field of perioperative care
are available, most of the recommendations were developed by experts in
the field through consensus processes involving utilization of evidence
grading to indicate the level of evidence upon which recommendations
were based. This guideline may not be appropriate for all clinical
situations and all patients. The decision whether to follow these
recommendations must be made by a responsible physician on an individual
basis. Protocols should be developed by individual institutions taking
into account the patients’ conditions, extent of interventions and
available resources.

This practice guideline is not intended to define
standards of care or represent absolute requirements for patient care.
The adherence to these guidelines cannot in any way guarantee successful
outcomes and is rather meant to help individuals and institutions
formulate plans to better deal with the challenges posed by
perioperative patients with OSA. These recommendations reflect the
current state of knowledge and its interpretation by a group of experts
in the field at the time of publication. While these guidelines will be
periodically updated, new information that becomes available between
updates should be taken into account. Deviations in practice from
guidelines may be justifiable and such deviations should not be
interpreted as a basis for claims of negligence.

Thursday, August 4, 2016

Dear Respiratory Friends, we are happy to present you fresh article Impact of anemia on short-term survival in severe COPD exacerbations: a cohort study from Journal of COPD by our Turkish friends Begum Ergan and Recai Ergün!!!

Purpose: Anemia is reported to be an independent
predictor of hospitalizations and survival in COPD. However, little is
known of its impact on short-term survival during severe COPD
exacerbations. The primary objective of this study was to determine
whether the presence of anemia increases the risk of death in acute
respiratory failure due to severe COPD exacerbations.

Patients and methods: Consecutive
patients with COPD exacerbation who were admitted to the intensive care
unit with the diagnosis of acute respiratory failure and required
either invasive or noninvasive ventilation (NIV) were analyzed.

Results:
A total of 106 patients (78.3% male; median age 71 years) were included
in the study; of them 22 (20.8%) needed invasive ventilation
immediately and 84 (79.2%) were treated with NIV. NIV failure was
observed in 38 patients. Anemia was present in 50% of patients, and 39
patients (36.8%) died during hospital stay. When compared to nonanemic
patients, hospital mortality was significantly higher in the anemic
group (20.8% vs 52.8%, respectively; P=0.001). Stepwise
multivariate logistic regression analysis showed that presence of anemia
and NIV failure were independent predictors of hospital mortality with
odds ratios (95% confidence interval) of 3.99 ([1.39–11.40]; P=0.010) and 2.56 ([1.60–4.09]; P<0.001), respectively. Anemia was not associated with long-term survival in this cohort. Conclusion: Anemia may be a risk factor for hospital death in severe COPD exacerbations requiring mechanical ventilatory support.

Wednesday, August 3, 2016

Welcome from ERS President Jørgen Vestbo

It is a true pleasure to be hosting the 26th International Congress of the European Respiratory Society in London.

The ERS International Congress has grown to be the largest meeting in
the world in the respiratory field and this year's event will not
disappoint. The Chairs of the Scientific and Educational Councils,
together with all ERS Officers, are busy preparing a programme that will
challenge our thinking minds, encourage debate and offer new insights
across the spectrum of respiratory health and disease.The ERS
International Congress has grown to be the largest meeting in the world
in the respiratory field and this year's true pleasure to be hosting the
26th International Congress of the European Respiratory Society in
London.

We extend a special welcome to our existing and new members as we
have seen our numbers rise this year with more partnerships developed
with national and international societies. The Congress is the pinnacle
of the year for our growing respiratory community, and others who attend
our Congress, and represents a key opportunity to share knowledge
across borders and professional disciplines as we work towards a common
goal of improving respiratory health.

This year will see the most interactive Congress experience
available. Alongside our official Congress app, we will partner with
SpotMe, a highly effective networking app available for free for all
delegates. The app will allow you to navigate the programme, network,
access session materials, use the interactive floor plan and exhibition
map, interact with faculty, access CME points, collect Congress
materials, watch missed sessions and much more. More information on this
will be shared on the website and in our newsletter.

Also, the venue is spectacular. It offers lots of space, also for
sitting down with colleagues and collaborators for networking – one of
the main attractions for coming to an ERS International Congress.

I look forward to welcoming you to London for the most exciting event in the respiratory calendar.

Tuesday, August 2, 2016

American
association of clinical endocrinologists and American college of endocrinology published recently
clinical practice guidelines for comprehensive medical care of patients with
obesity! Take a look sleep apnea and asthma are included for obligatory screening!

Obstructive sleep apnea• R21. All patients with overweight or obesity should be evaluated for obstructive sleep apnea during medical history and physical examination; this is based on the strong association of these disorders with each other (Grade B; BEL 2).Polysomnography and other sleep studies, at home or in a sleep lab, should be considered for patients at high risk for sleep apnea based on clinical presentation, severity of excess adiposity, and symptomatology (Grade D). All patients withobstructive sleep apnea should be evaluated for the presence of overweight or obesity (Grade B; BEL 2).

Asthma/reactive airway disease• R22. All patients with overweight or obesity should be evaluated for asthma and reactive airway disease based on the strong association of these disorders with each other (Grade B; BEL 2). Based on medical history, symptomatology, andphysical examination, spirometry and other pulmonary function tests should be considered for patients at high risk for asthma and reactive airway disease (Grade D). All patients with asthma should be evaluated for the presence ofoverweight or obesity (Grade D).

Read COPD Research and Practice

COPD Research and Practice publishes basic and clinical research and review articles relating to the development, progression and treatment of COPD and related disorders

Read Current Respiratory Medicine Reviews

Current Respiratory Medicine Reviews publishes original research papers, frontier reviews, drug clinical trial studies and guest edited issues dedicated to clinical research on all the latest advances on respiratory diseases